[HN Gopher] Longitudinal analysis shows durable immune memory af...
       ___________________________________________________________________
        
       Longitudinal analysis shows durable immune memory after SARS-CoV-2
       infection
        
       Author : briefcomment
       Score  : 185 points
       Date   : 2021-08-08 15:07 UTC (7 hours ago)
        
 (HTM) web link (www.cell.com)
 (TXT) w3m dump (www.cell.com)
        
       | unanswered wrote:
       | Real facts that people won't like to hear: anyone who thought
       | differently probably needs to retake a high school biology class.
        
         | [deleted]
        
         | ebiester wrote:
         | The problem is that you think a high school biology class is
         | sufficient to understand the broader implications.
         | 
         | What is the limitation of this study? For example, in the
         | context of the paper, "immunity" means that your immune system
         | mounts an immediate response. Do the antibodies created attack
         | variants equally effectively relative to vaccines? Are they
         | better? Worse?
         | 
         | This paper is one data point. Your high school biology class
         | won't teach you how to understand the limitations of the paper.
         | That's why we have people who study this for decades.
         | 
         | Don't mistake your "high school biology class" with expertise.
        
           | ad404b8a372f2b9 wrote:
           | I suspect nobody commenting here is equipped to analyze
           | critically the science being done either on the virus or the
           | vaccine, yet everybody speaks with authority on what's
           | relevant and what's bullhockey.
           | 
           | A high-school biology class will give you good general priors
           | and instincts about how things generally work and is as good
           | as you're gonna get trying to understand what's going on
           | currently without a relevant degree or a few years of
           | hindsight for the politicization to die down. Infections
           | generally leave antibodies behind therefore I'm going to
           | assume people who have been infected have some immunity to
           | this variant. Masks reduce the spread of spit therefore I'm
           | going to assume they are generally useful to combat the
           | spread.
           | 
           | I'm sure this will strike some as being anti-science but
           | having seen how the sausage gets made wrt science and
           | medicine I don't trust myself or the journalists to interpret
           | or qualify the new results we get every week.
        
           | BrianOnHN wrote:
           | This is a great example of the Dunning-Kruger effect[1].
           | 
           | [1]
           | https://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect
        
       | dzink wrote:
       | Immunity persists for a while but doesn't seem to stop the new
       | variants. Another study shows that re-infection with Covid is a
       | lot more likely in unvaccinated people than in vaccinated.
        
         | lazyjones wrote:
         | Data from Israel shows that vaccinated people have a 6.72 times
         | higher chance to get infected than previously infected people:
         | https://www.israelnationalnews.com/News/News.aspx/309762
        
           | mikem170 wrote:
           | That's interesting!
           | 
           | > More than 7,700 new cases of the virus have been detected
           | during the most recent wave starting in May, but just 72 of
           | the confirmed cases were reported in people who were known to
           | have been infected previously - that is, less than 1% of the
           | new cases.
           | 
           | > Roughly 40% of new cases - or more than 3,000 patients -
           | involved people who had been infected despite being
           | vaccinated.
           | 
           | Optimistically both vaccine and natural immunity are good,
           | but the numbers above seem to indicate that natural immunity
           | is significantly better.
        
           | jetpks wrote:
           | Do you have a moderately credible source on this? The linked
           | is pushing a radical right-wing hard-line anti-vaccine agenda
           | too hard to be considered remotely credible or trustworthy.
           | It also does not link to primary sources.
        
             | lazyjones wrote:
             | Perhaps this: https://www.msn.com/en-us/health/medical/dr-
             | makary-says-natu... or
             | https://www.timesofisrael.com/liveblog_entry/are-
             | recovered-c... but I can't find the original study or
             | channel 13 report because I don't speak Hebrew.
        
         | thih9 wrote:
         | Do you or anyone else have a link to the other study?
        
         | tchalla wrote:
         | > Now, a new NIH-supported study shows that the answer to this
         | question will vary based on how an individual's antibodies
         | against SARS-CoV-2 were generated: over the course of a
         | naturally acquired infection or from a COVID-19 vaccine. The
         | new evidence shows that protective antibodies generated in
         | response to an mRNA vaccine will target a broader range of
         | SARS-CoV-2 variants carrying "single letter" changes in a key
         | portion of their spike protein compared to antibodies acquired
         | from an infection.
         | 
         | https://directorsblog.nih.gov/2021/06/22/how-immunity-genera...
        
       | [deleted]
        
       | criticaltinker wrote:
       | This paper further supports the fact that naturally acquired
       | immunity to SARS-CoV-2 is 1) robust and 2) durable.
       | 
       | 1) Robust means the immune response recognizes many different
       | parts of the virus.
       | 
       | 2) Durable means the immune response remains detectable - and
       | likely effective at protecting the individual - for a long period
       | of time.
       | 
       | A robust immune response is important because it provides a
       | certain degree of protection against variants of the virus.
       | 
       | This robustness is why some people hypothesize that natural
       | immunity provides better protection than vaccination - however
       | this hypothesis has not been conclusively proven in the
       | literature yet. If you're aware of primary sources that say
       | otherwise please share them.
       | 
       | For now, all available evidence strongly suggests that
       | individuals with naturally acquired immunity are at least equally
       | well protected as individuals who have been vaccinated. Here are
       | a couple more supporting references [1][2].
       | 
       | As a final point - in the literature there is some evidence &
       | concern that the current mRNA vaccines induce an immune response
       | which is highly targeted toward the spike protein [3]. When
       | combined with mass vaccination campaigns, this creates tremendous
       | selective pressure that can further enhance the fitness of the
       | virus, and lead to increasingly infectious or virulent variants
       | [3][4][5][6].
       | 
       | It's clear that vaccination poses little additional risk - but
       | also little benefit - to previously infected individuals, and
       | consequently our vaccination campaigns should be highly targeted
       | toward vulnerable demographics to reap the most benefits and
       | minimize the risks to public health.
       | 
       | [1] SARS-CoV-2 infection induces long-lived bone marrow plasma
       | cells in humans
       | https://www.nature.com/articles/s41586-021-03647-4.pdf
       | 
       | [2] Necessity of COVID-19 vaccination in previously infected
       | individuals
       | https://www.medrxiv.org/content/10.1101/2021.06.01.21258176v...
       | 
       | [3] Risk of rapid evolutionary escape from biomedical
       | interventions targeting SARS-CoV-2 spike protein
       | https://pubmed.ncbi.nlm.nih.gov/33909660/
       | 
       | [4] SARS-CoV-2 immune evasion by the B.1.427/B.1.429 variant of
       | concern
       | https://science.sciencemag.org/content/early/2021/06/30/scie...
       | 
       | [5] mRNA vaccine-elicited antibodies to SARS-CoV-2 and
       | circulating variants
       | https://www.nature.com/articles/s41586-021-03324-6
       | 
       | [6] Imperfect Vaccination Can Enhance the Transmission of Highly
       | Virulent Pathogens
       | https://journals.plos.org/plosbiology/article?id=10.1371%2Fj...
        
         | bmer wrote:
         | Reference [1] is applicable to how our body handles an immune
         | response to the viral infection in general: i.e. whether
         | naturally acquired, or through controlled vaccination. Natural
         | infections were, naturally focused upon, in order to understand
         | the baseline dynamics of viral infection.
         | 
         | Reference [2] is...it says just as much about the efficacy of
         | vaccination as the efficacy of natural immunity:
         | 
         | > The cumulative incidence of SARS-CoV-2 infection remained
         | almost zero among previously infected unvaccinated subjects,
         | previously infected subjects who were vaccinated, and
         | previously uninfected subjects who were vaccinated, compared
         | with a steady increase in cumulative incidence among previously
         | uninfected subjects who remained unvaccinated.
         | 
         | Read reference [3] to understand why natural immunity doesn't
         | cut it. Note that widespread natural immunity causes the same
         | positive selection pressure as widespread vaccine deployment,
         | and:
         | 
         | > Finally, our work suggests that immune evasion requiring one
         | to two mutations occurs within months, raising the prospect
         | that this phenomenon will further shorten the duration of
         | natural immunity...
         | 
         | The paper goes on to provide (under Discussion) a series of
         | strategies for developing a vaccination system that takes into
         | account modelled viral evolution. Can't come up with strategies
         | like that for natural immunity, apart from: "periodically re-
         | infect individual"...which is exactly what vaccines do, in a
         | controlled manner.
         | 
         | Reference [4] and [5] are research tabulating mutations the
         | virus is undergoing to counter both natural acquired and
         | vaccine-mediated immune responses. It is not an indictment
         | against vaccines, but just like paper [3], provide strategies
         | on how to update vaccines. That updates will be required is not
         | a surprise to anyone. Viral evolution has long been known of,
         | and no one expected the emergency COVID-19 vaccines to be
         | effective until the end of time.
         | 
         | Reference [6]...did you read it? It's about vaccines which
         | protect the host(keep them alive), but still keep them
         | infectious (capable of transmission). None of the COVID-19
         | vaccines do that...
        
           | criticaltinker wrote:
           | Are you trying to refute the claim that natural infection
           | confers immunity that is at least equally as protective as
           | vaccination?
           | 
           | It's not clear to me that you've presented any counter
           | evidence. I will try to outline my thoughts on your comment
           | to help the discussion.
           | 
           | [1] is another primary source beyond the OP that demonstrates
           | the durability of the immune response from natural infection.
           | We are in agreement that in principle the immune response
           | from vaccination should also be durable due to relying on the
           | same underlying mechanisms of the immune system - in fact I
           | am unaware of any literature which demonstrates otherwise. So
           | your point about [1] doesn't seem particularly relevant to
           | me.
           | 
           | > Reference [2] is...it says just as much about the efficacy
           | of vaccination as the efficacy of natural immunity
           | 
           | Yes you're right, and that is a relevant quote you pulled
           | from the abstract. Again, I think we're actually in agreement
           | here - the findings support my original claims.
           | 
           | > Read reference [3] to understand why natural immunity
           | doesn't cut it. Note that widespread natural immunity causes
           | the same positive selection pressure as widespread vaccine
           | deployment
           | 
           | You seem to be missing the central thesis of [3], here are
           | the relevant excerpts:
           | 
           | - "The spike protein receptor-binding domain (RBD) of SARS-
           | CoV-2 is the molecular target for many vaccines and antibody-
           | based prophylactics aimed at bringing COVID-19 under
           | control."
           | 
           | - "Such a narrow molecular focus raises the specter of viral
           | immune evasion as a potential failure mode for these
           | biomedical interventions. With the emergence of new strains
           | of SARS-CoV-2 with altered transmissibility and immune
           | evasion potential, a critical question is this: how easily
           | can the virus escape neutralizing antibodies (nAbs) targeting
           | the spike RBD?"
           | 
           | - "Our modeling suggests that SARS-CoV-2 mutants with one or
           | two mildly deleterious mutations are expected to exist in
           | high numbers due to neutral genetic variation, and
           | consequently resistance to vaccines or other prophylactics
           | that rely on one or two antibodies for protection can develop
           | quickly -and repeatedly- under positive selection."
           | 
           | - "The speed at which nAb resistance develops in the
           | population increases substantially as the number of infected
           | individuals increases, suggesting that complementary
           | strategies to prevent SARS-CoV-2 transmission that exert
           | specific pressure on other proteins (e.g., antiviral
           | prophylactics) or that do not exert a specific selective
           | pressure on the virus (e.g., high-efficiency air filtration,
           | masking, ultraviolet air purification) are key to reducing
           | the risk of immune escape"
           | 
           | - "Strategies for viral elimination should therefore be
           | diversified across molecular targets and therapeutic
           | modalities"
           | 
           | We are in agreement [4] and [5] are not an indictment against
           | vaccines - but again you seem to be missing the most
           | important and highly relevant findings which support my
           | claims.
           | 
           | For example from [4]:
           | 
           | - "The acquisition of the L452R substitution by multiple
           | lineages across multiple continents, including the B.1.617.1
           | and B.1.617.2 lineages emerging in India (54), is suggestive
           | of positive selection, which might result from the selective
           | pressure of RBD-specific neutralizing Abs"
           | 
           | - "Our data support that the SARS-CoV-2 NTD evolved a
           | compensatory mechanism to form an alternative disulfide bond
           | and that mutations of the S signal peptide occur in vivo in a
           | clinical setting to promote immune evasion."
           | 
           | - "Understanding the newly found mechanism of immune evasion
           | in emerging SARS-CoV-2 variants, such as the signal peptide
           | modification described herein, is as important as sequence
           | surveillance itself to successfully counter the ongoing
           | pandemic."
           | 
           | For example from [5]:
           | 
           | - "different individuals immunized with the Moderna
           | (mRNA-1273) or Pfizer-BioNTech (BNT162b2) vaccines produce
           | closely related, and nearly identical, antibodies."
           | 
           | - "To avert selection and escape, antibody therapies should
           | be composed of combinations of antibodies that target non-
           | overlapping or highly conserved epitopes"
           | 
           | - "We speculate that these mutations emerged in response to
           | immune selection in individuals with nonsterilizing
           | immunity."
           | 
           | > Reference [6]...did you read it? It's about vaccines which
           | protect the host(keep them alive), but still keep them
           | infectious (capable of transmission). None of the COVID-19
           | vaccines do that...
           | 
           | You are incorrect - the current spike protein focused mRNA
           | based vaccines do not guarantee sterilizing immunity - that
           | means you can be vaccinated yet still get infected and
           | transmit the virus to others. Please cite your sources if
           | you're going to make such claims.
        
       | SideburnsOfDoom wrote:
       | Not to disagree with the effectiveness of immunity gained by
       | getting Covid-19, but also:
       | 
       | "The evidence shows that protective antibodies generated in
       | response to an mRNA vaccine will target a broader range of SARS-
       | CoV-2 variants ... compared to antibodies acquired from an
       | infection."
       | 
       | https://directorsblog.nih.gov/2021/06/22/how-immunity-genera...
       | 
       | "Vaccination offers longer, stronger immunity"
       | 
       | https://www.jhsph.edu/covid-19/articles/why-covid-19-vaccine...
       | 
       | "Why a vaccine can provide better immunity than an actual
       | infection"
       | 
       | https://theconversation.com/why-a-vaccine-can-provide-better...
       | 
       | "Why You Need to Get Vaccinated Even If You've Already Had
       | COVID-19"
       | 
       | https://www.healthline.com/health-news/why-you-need-to-get-v...
       | 
       | And also, vaccination is a much, much safer way to get
       | antibodies, than via getting sick with Covid-19.
        
         | eightysixfour wrote:
         | To add to the list:
         | 
         | "Kentucky residents who were not vaccinated had 2.34 times the
         | odds of reinfection compared with those who were fully
         | vaccinated (odds ratio [OR] = 2.34; 95% confidence interval
         | [CI] = 1.58-3.47). These findings suggest that among persons
         | with previous SARS-CoV-2 infection, full vaccination provides
         | additional protection against reinfection."
         | 
         | https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm...
        
           | criticaltinker wrote:
           | Here is a paper (not yet peer-reviewed) which presents
           | statistically strong evidence (N = 52,238) that vaccinating
           | previously infected individuals provides practically no
           | benefit [1].
           | 
           | Quote from [1]:
           | 
           | - "The cumulative incidence of SARS-CoV-2 infection remained
           | almost zero among previously infected unvaccinated subjects,
           | previously infected subjects who were vaccinated, and
           | previously uninfected subjects who were vaccinated, compared
           | with a steady increase in cumulative incidence among
           | previously uninfected subjects who remained unvaccinated."
           | 
           | Right now there is no scientific consensus that full
           | vaccination of previously infected individuals provides any
           | additional protection that is meaningfully beneficial. In
           | fact there is a lot of evidence pointing the other way -
           | supporting the idea that vaccination strategies should be
           | highly targeted at only the most vulnerable populations.
           | 
           | [1] Necessity of COVID-19 vaccination in previously infected
           | individuals https://www.medrxiv.org/content/10.1101/2021.06.0
           | 1.21258176v...
        
             | raphlinus wrote:
             | Thanks for bringing this paper, it's relevant to the
             | conversation. A couple of points of context.
             | 
             | First, this study is quite early on in the vaccination
             | campaign, when supplies were very short. The main
             | conclusion is that they should be _prioritized_ to people
             | who have not had prior infection. That advice was not
             | followed, largely because determining prior infection
             | status complicates the protocols for vaccination quite a
             | bit, and simpler is better. Now, at least in the US, we 're
             | in a situation where we are literally throwing vaccine down
             | the drain[1, 2].
             | 
             | Second, this study in particular predates the significant
             | spread of the delta variant, and there is particular
             | concern about reinfection from that variant[3]. Vaccine
             | effectiveness appears to be somewhat reduced compared with
             | the original variant, but still pretty good.
             | 
             | This is definitely an area where more science is needed.
             | 
             | [1]: https://www.statnews.com/2021/07/20/states-are-
             | sitting-on-mi...
             | 
             | [2]: https://www.al.com/coronavirus/2021/08/alabama-threw-
             | out-650...
             | 
             | [3]: https://www.nature.com/articles/s41586-021-03777-9
        
               | criticaltinker wrote:
               | > The main conclusion is that they should be prioritized
               | to people who have not had prior infection
               | 
               | You're leaving out the primary finding, here is the
               | actual conclusion from the study I previously cited [1]:
               | 
               | - "Individuals who have had SARS-CoV-2 infection are
               | unlikely to benefit from COVID-19 vaccination, and
               | vaccines can be safely prioritized to those who have not
               | been infected before."
               | 
               | > this study in particular predates the significant
               | spread of the delta variant, and there is particular
               | concern about reinfection from that variant
               | 
               | I agree on the general point. Relevant to the discussion
               | is the fact that the OP paper addresses this, here are
               | relevant excerpts:
               | 
               | - "Our findings show that most COVID-19 patients induce a
               | wide-ranging immune defense against SARS-CoV-2 infection,
               | encompassing antibodies and memory B cells recognizing
               | both the RBD and other regions of the spike, broadly-
               | specific and polyfunctional CD4+ T cells, and
               | polyfunctional CD8+ T cells."
               | 
               | - "The immune response to natural infection is likely to
               | provide some degree of protective immunity even against
               | SARS-CoV-2 variants because the CD4+ and CD8+ T cell
               | epitopes will likely be conserved."
               | 
               | - "Thus, vaccine induction of CD8+ T cells to more
               | conserved antigens such as the nucleocapsid, rather than
               | just to SARS-CoV-2 spike antigens, may add benefit to
               | more rapid containment of infection as SARS-CoV-2
               | variants overtake the prevailing strains."
               | 
               | These findings hint that naturally acquired immunity may
               | actually be more robust to variants of concern in
               | comparison to the immune response induced by vaccination.
               | But admittedly this has not been proven yet.
               | 
               | See my top level post on this thread for more details and
               | citations.
        
           | rubatuga wrote:
           | Observational evidence of course, meaning plenty of
           | confounders.
        
             | timr wrote:
             | Also a very small study of N=246, which is why the
             | confidence interval on the OR is so large.
        
         | briefcomment wrote:
         | Probably not as clear cut as that. The OP study suggests that
         | vaccines can be improved from learnings from natural immunity.
         | 
         | > "Overcoming the challenges to end the pandemic is accentuated
         | by the recognition that SARS-CoV-2 can undergo rapid antigenic
         | variation that may lower vaccine effectiveness in preventing
         | new cases and progression to severe disease. Our findings show
         | that most COVID-19 patients induce a wide-ranging immune
         | defense against SARS-CoV-2 infection, encompassing antibodies
         | and memory B cells recognizing both the RBD and other regions
         | of the spike, broadly-specific and polyfunctional CD4+ T cells,
         | and polyfunctional CD8+ T cells. The immune response to natural
         | infection is likely to provide some degree of protective
         | immunity even against SARS-CoV-2 variants because the CD4+ and
         | CD8+ T cell epitopes will likely be conserved. Thus, vaccine
         | induction of CD8+ T cells to more conserved antigens such as
         | the nucleocapsid, rather than just to SARS-CoV-2 spike
         | antigens, may add benefit to more rapid containment of
         | infection as SARS-CoV-2 variants overtake the prevailing
         | strains."
        
         | timr wrote:
         | I am a believer in vaccines, but you're mischaracterizing the
         | first link by selective omission. You've cut out the critical
         | words of the sentence (emphasized):
         | 
         | > The new evidence shows that protective antibodies generated
         | in response to an mRNA vaccine will target a broader range of
         | SARS-CoV-2 variants _carrying "single letter" changes in a key
         | portion of their spike protein_ compared to antibodies acquired
         | from an infection.
         | 
         | The paper shows that vaccines produce a more diverse antibody
         | response _to the RBD_ , which is one portion of the spike
         | protein. They admit that natural infection produces antibodies
         | targeted to _other_ portions of the spike protein (also,
         | presumably, to other parts of the virus, though that isn 't
         | discussed in this press release):
         | 
         | > Specifically, antibodies elicited by the mRNA vaccine were
         | more focused to the RBD compared to antibodies elicited by an
         | infection, which more often targeted other portions of the
         | spike protein.
         | 
         | Is this evidence that vaccines are "better" than natural
         | infection? No. It can't be. The paper shows that there's a
         | _difference_ between the antibody responses, but beyond that,
         | it 's impossible to know what the practical impacts of that
         | difference might be from this paper.
         | 
         | This is a perfect example of the political weaponization of
         | pre-prints that has happened throughout the pandemic. People
         | read these things, don't fully understand what they're reading
         | or what questions they answer, and immediately jump to social
         | media to start waving them around like team flags (and worse,
         | people _who should know better_ -- like Francis Collins -- seem
         | to encourage the behavior. This PR seems to be trying very hard
         | to mislead, without actually stepping over the line.)
         | 
         | This is an interesting paper, but it is in no way a definitive
         | statement about the relative benefits of vaccination vs.
         | natural immunity.
        
           | SideburnsOfDoom wrote:
           | Thank you for adding nuance. This topic is indeed in sore
           | need of more nuance.
        
           | raphlinus wrote:
           | Thanks for trying to bring more precision to the discussion.
           | I also cited that blog post elsethread, and, having reviewed
           | it, agree it's not the single best piece of evidence. It
           | establishes a narrow result which _suggests_ a generally
           | better immune response from vaccines, but does not prove it.
           | 
           | If I had to cite a single preprint to support the assertion,
           | it would probably be this one:
           | 
           | https://www.biorxiv.org/content/10.1101/2021.04.15.440089v4
           | 
           | Obviously this study also has limitations: it speaks only to
           | Ab levels, while obviously the overall immune response is a
           | lot more complicated.
           | 
           | I agree with the "waving of preprints" claim. Unfortunately,
           | hyperskepticism, rejecting drawing conclusions because of the
           | inevitable limitations of any study, is also a politicized
           | position, and unfortunately I see a fair amount of that as
           | well.
        
             | criticaltinker wrote:
             | Thanks for the citation, I hadn't seen that paper yet.
             | 
             | I agree it predominantly speaks to antibody levels. For
             | others reading who don't already know - antibody levels are
             | used as proxy to measure immune protection, but currently
             | there is no scientific consensus that increasingly higher
             | antibody levels correspond to increasingly better
             | protection. Similarly, it is difficult to determine at what
             | antibody levels an individual is "protected enough". So
             | answering those questions is an ongoing scientific
             | endeavor.
             | 
             | With that said, the literature is rapidly approaching (and
             | likely has already established) scientific consensus that
             | vaccination increases many components of the humoral
             | response to SARS-CoV-2 infection. But for the reasons I
             | previously stated, this has not been proven to translate
             | into better protection or additional benefits for
             | previously infected individuals.
             | 
             | So while antibody levels are a useful measure, another
             | important factor is the robustness of the vaccine induced
             | immune responses in comparison to the response induced in
             | naturally infected individuals. There is a relevant section
             | in the paper you cited titled 'mRNA vaccines induce higher
             | Ab levels and greater Ab breadth than natural exposure to
             | infection'.
             | 
             | My takeaway is that the authors are concluding that the
             | vaccine induces a more robust antibody response because
             | "the vaccine induced significant cross-reactive Abs against
             | the SARS spike and SARS RBD". However they also clearly
             | state that the vaccine does not induce antibodies against
             | the nucleocapsid protein, which natural infection does.
             | 
             | For these reasons I feel that characterizing the vaccine
             | induced immune response as "more robust" doesn't really
             | paint an accurate picture. Especially when it has yet to be
             | proven that this difference in immune response is actually
             | beneficial for health outcomes in people infected with the
             | virus.
             | 
             | Here are some key excerpts:
             | 
             | - "The nucleocapsid protein (NP) is an immunodominant
             | antigen for which the antibody response increases in
             | concordance with natural exposure (Figure 2A,3A and 4)."
             | 
             | - "However, nucleocapsid is not a component of the mRNA
             | vaccines and consequently there is no vaccine-induced
             | increase in Ab against this antigen. Accordingly, anti-
             | spike antibody levels increased in vaccinees while the
             | nucleocapsid protein Ab level remained constant."
             | 
             | - "Natural exposure in seropositive people induces high
             | antibody levels against nucleocapsid protein (NP), full-
             | length spike (S1+S2) and the S2 domain. Antibodies against
             | S1 and the RBD domains are lower."
             | 
             | - "Vaccinated individuals have high Ab levels against full-
             | length spike and the S2 domain of SARS-CoV-2 spike, and
             | significantly higher antibody levels against S1 and the RBD
             | domains compared to naturally exposed individuals."
             | 
             | - "In natural exposure there was no significant cross-
             | reactivity against SARS S1 or the RBD domains.
             | Surprisingly, the vaccine induced significant cross-
             | reactive Abs against the SARS spike and SARS RBD."
             | 
             | - "Vaccination induces a more robust antibody response than
             | natural exposure alone, SUGGESTING that those who have
             | recovered from COVID benefit from the vaccination with
             | stronger and broader antibody response."
        
             | nwienert wrote:
             | We know based on past corornaviruses that natural infection
             | can lead to durable immunity up to 20 years, and like you
             | mentioned with T-cells and more. We also have data showing
             | the current ones so far last as long as we've tested them,
             | while vaccines have waned once near a year out. The
             | consensus hasn't been reached, by my current beliefs
             | strongly tend towards (based on many past similar viruses
             | and all current studies) that vaccine is far less
             | efficacious.
             | 
             | https://www.israelnationalnews.com/News/News.aspx/309762
             | 
             | Note: that's 6.7 times stronger immunity from natural vs
             | vaccinated! If anything we should have "previously-
             | infected" cards that confer far greater privileges than
             | vaccination cards, if we're going to be playing that silly
             | game.
             | 
             | Here's a citation showing stronger T cell immunity from
             | naturally infected:
             | https://science.sciencemag.org/content/372/6549/1418
             | 
             | Natural infection stronger across the board:
             | 
             | https://www.google.com/amp/s/www.news-
             | medical.net/amp/news/2...
             | 
             | Natural immunity holds across even previously known
             | coronavirus variants:
             | 
             | https://news.emory.edu/stories/2021/07/covid_survivors_resi
             | s...
        
               | raphlinus wrote:
               | _Antibodies_ wane, but B-cell and T-cell response is
               | important for longer term protection. Fortunately, we
               | have results (including [B] and [T]) that vaccines also
               | induce these memory cell responses.
               | 
               | Also, the durability of immunity from coronavirus
               | probably depends on the exact coronavirus. It does seem
               | to be true for SARS, but possibly less so for the
               | seasonal coronaviruses that cause a respectable fraction
               | of common colds[3]. We don't really know yet where SARS-
               | CoV-2 falls on that spectrum.
               | 
               | [B]: https://www.medrxiv.org/content/10.1101/2021.07.12.2
               | 1259864v...
               | 
               | [T]: https://www.medrxiv.org/content/10.1101/2021.06.30.2
               | 1259787v...
               | 
               | [3]: https://www.nature.com/articles/s41591-020-1083-1
        
               | nwienert wrote:
               | While they may stimulate some B and T, they aren't close
               | to the levels from infection.
               | 
               | From what I've seen many coronavirus have durable
               | immunity from infection, you'd need to cite that they
               | vary. Also, from what I've seen the T and B cell response
               | is not nearly the same effect, nor as durable.
               | 
               | Further, like the Israeli report, there are a handful
               | more reports of previously infected not getting
               | reinfected at nearly the same rates. The Israeli report
               | has hard numbers in the article you ignored.
        
               | raphlinus wrote:
               | I think you added the links in an edit?
               | 
               | The Science cite shows something that's very different
               | than what people might take from your comment. Briefly,
               | prior infection plus one mRNA dose induces a very good
               | immune response, much better than a single dose without
               | prior infection. It does not compare two mRNA doses
               | against prior infection.
               | 
               | I believe the cite I provided _does_ support the idea
               | that coronaviruses vary, in particular that HCoV-229E
               | exhibits continuous genetic drift. But here 's an
               | excellent paper that goes into a lot more detail on that:
               | https://journals.plos.org/plospathogens/article?id=10.137
               | 1/j...
        
               | dsyrk wrote:
               | The idea that two mRNA dose immunity is superior on
               | average to those recovered with natural immunity is
               | absurd. I haven't reviewed your sources yet, but if you
               | have such a source then you are cherry picking among
               | numerous other results that disagree. Antibody levels can
               | be lower but effective protection against re-infection is
               | very high because memory cells can generate antibodies on
               | demand. Natural antibodies target numerous areas of the
               | virus and are more resilient to variants. Additionally
               | recovered individuals who receive an mRNA dose have the
               | highest levels of measured antibodies.
               | 
               | Why are you trying to arguing something that is clearly
               | false? Do you have a political objective of some sort?
        
         | nickthemagicman wrote:
         | I love how the top comment is links to 4 opinion piece articles
         | two of which are from healthline.com and theconversation.com.
         | 
         | "Citations"
         | 
         | My high school English teacher would be disappointed in this
         | site.
         | 
         | I'm sure there's a bunch of actual scientific articles below
         | that are flagged because they are going against the narrative.
         | 
         | Don't ever change HN.
        
         | phkahler wrote:
         | We can cherry pick papers all day long to support or refute the
         | idea that having had Covid19 is equivalent/better/worse than
         | getting the vaccine. Anyone being honest can see that the jury
         | is still out on the issue. But I can state 2 things with
         | certainty. 1) having had it does offer some degree of
         | immunization. 2) there is a lot of evidence that those spike
         | proteins do damage. Given that, I dont know why some people
         | lump previously infected folks in with anti-vaxxers. It's not
         | even close to the same thinking.
        
           | mmcnl wrote:
           | > there is a lot of evidence that those spike proteins do
           | damage
           | 
           | Citation needed.
        
         | arein3 wrote:
         | you can look at jewish data
         | 
         | for a highly vaccinated population 50% newly infected are
         | unvaccinated, 50% are vaccinated and only 1% are getting the
         | virus the second time
        
       | mbgerring wrote:
       | "Acquiring" natural immunity also has the following side effects
       | at a much higher rate than the vaccine:
       | 
       | - Death
       | 
       | - Hospitalization
       | 
       | - Chronic illness, which can include long-term neurological
       | impairment
       | 
       | I feel like it's important to keep that in mind if you're either
       | advocating "natural immunity" as a public health strategy, or
       | considering it a personal strategy.
        
         | landemva wrote:
         | Much of the death toll centers on those who are already sick,
         | obese, and otherwise compromised. Age groups of children and
         | young adults show remarkable resilience to infection. There is
         | not one outcome.
        
           | AnthonBerg wrote:
           | So you would have us call to those who are already tired and
           | add death to their burden?
           | 
           | I doubt it?
        
           | nicoburns wrote:
           | There is nevertheless a significantly lower incidence of
           | negative effects from the vaccine than from a covid infection
           | in all age groups.
        
         | nullc wrote:
         | > "Acquiring" natural immunity also has the following side
         | effects at a much higher rate than the vaccine: > - Death
         | 
         | The pfizer vaccine clinical trial had equal rates of death
         | among vaccine and placebo recipients, FWIW.
         | 
         | I don't believe any RCT has validated the claim that
         | vaccination reduces the recipients chance of death.
         | 
         | (Nor has any validated that parachutes save lives, I suppose!)
        
         | slumpt_ wrote:
         | Vaccination also has more durable immunity than natural
         | immunity in this case. Without those risks you outline.
        
           | nickthemagicman wrote:
           | * Citation needed.
        
           | wizzwizz4 wrote:
           | I expected this for the mRNA vaccine, but source?
        
             | tchalla wrote:
             | > Now, a new NIH-supported study shows that the answer to
             | this question will vary based on how an individual's
             | antibodies against SARS-CoV-2 were generated: over the
             | course of a naturally acquired infection or from a COVID-19
             | vaccine. The new evidence shows that protective antibodies
             | generated in response to an mRNA vaccine will target a
             | broader range of SARS-CoV-2 variants carrying "single
             | letter" changes in a key portion of their spike protein
             | compared to antibodies acquired from an infection.
             | 
             | https://directorsblog.nih.gov/2021/06/22/how-immunity-
             | genera...
        
               | [deleted]
        
           | [deleted]
        
           | anonuser123456 wrote:
           | I'm not sure this is clear. Yes, this is what has been stated
           | in the media, but I have yet to see data to back the claim.
           | 
           | And in particular it has been shown that natural immunity
           | produces a much broader set of antibodies that may allow the
           | immune system to cope with variants better.
           | 
           | I'm not advocating natural immunity btw. I completely agree
           | people should get the vaccine.
        
             | slumpt_ wrote:
             | That's actually incorrect. Someone was kind enough to cite
             | in another reply to me.
             | 
             | I'm honestly a bit disturbed how much confidence software
             | engineers have in their consumption of virology research.
             | My good friend has worked in it for 10+ years not including
             | a doctorate and worked on an mRNA vaccine.
             | 
             | I trust his takes more than any media and certainly more
             | than some of these folks replying doubting the state of the
             | science. Vaccines are the safest and best protection
             | against COVID one can get.
             | 
             | Not specifically replying to you with that, just the
             | general tone of these threads. Folks are out of their
             | depth.
        
               | anonuser123456 wrote:
               | Hi Pot, meet Kettle?
               | 
               | My statement literally starts with "I'm not sure...". You
               | begin yours with "That's actually incorrect." Which
               | expresses more confidence?
               | 
               | My opinion is based on a conversation with a Ph.D
               | immunologist that happens to be a friend as well. And if
               | that's not enough here is a paper from a totally separate
               | lab that has similar conclusions, with actual data https:
               | //www.biorxiv.org/content/10.1101/2021.07.29.454333v1
               | 
               | mRNA vaccines are obviously much better at generating
               | antibodies for the RBD. That's an empirical fact, no one
               | is disputing that. But natural immunity presents antibody
               | targets beyond the RBD.
        
               | slumpt_ wrote:
               | If you finished the post, I mentioned I wasn't referring
               | to you.
               | 
               | With respect to the incorrect part, I was replying to:
               | 
               | "...it has been shown that natural immunity produces a
               | much broader set of antibodies that may allow the immune
               | system to cope with variants better."
               | 
               | Which is indeed wrong.
               | 
               | Hope that helps
        
         | chiefalchemist wrote:
         | Links please. If those at risk aren't given the jab then counts
         | of death and hospitalizations are going to be skewed against
         | the natural immunity.
        
         | briefcomment wrote:
         | That's a strawman. Can you instead address this particular
         | bucket: people who have had Covid, and are now wondering if
         | they are as immune as they can hope for, considering all other
         | available interventions.
        
           | SideburnsOfDoom wrote:
           | > people who have had Covid, and are now wondering if they
           | are as immune as they can hope for, considering all other
           | available interventions.
           | 
           | They are not "as immune as they can hope for" and would
           | benefit from vaccination, after having had COVID, in that
           | respect.
           | 
           | Links posted already, but mainly
           | https://www.healthline.com/health-news/why-you-need-to-
           | get-v...
        
           | plorg wrote:
           | I absolutely don't think it's a strawman. Nearly to a person,
           | the people in my life who have not gotten vaccinated and have
           | not yet gotten Covid-19, if asked, have been making this
           | argument: it's not that bad, it's not worth getting the
           | vaccine.
        
           | ramraj07 wrote:
           | Actually being infected with Covid (symptomatic) probably
           | does confer the best immunity possible, for sure. You should
           | still get vaccinated after that though, because research
           | suggests that vaccination can significantly help alleviate
           | long COViD symptoms which a large fraction of patients have.
           | Haven't seen actual numbers on the immunity boost conferred
           | by post-Covid vaccination though (no reason to think it'll
           | not add at least a slight bit).
        
             | tchalla wrote:
             | > Actually being infected with Covid (symptomatic) probably
             | does confer the best immunity possible, for sure.
             | 
             | I don't think so. We have multiple links in this thread
             | that say otherwise.
        
             | maxerickson wrote:
             | The stabilized spike used in several of the vaccines
             | appears to offer better resistance to new infection than
             | convalescent immunity.
             | 
             | (The theory is that the vaccine antibodies do a better job
             | of binding to the active site on infectious virus particles
             | than the antibodies induced from infection, which bind to
             | whichever part of the virus, and may bind to the form the
             | active site takes after attaching to a cell, rather than
             | prior)
             | 
             | Also, getting the vaccine as early as it is available is a
             | better way to avoid long Covid than getting the vaccine
             | after you've had a course of infection.
        
           | jchw wrote:
           | Not being or knowing people applicable to the comment does
           | not make it a straw man.
           | 
           | Anyway, available sources so far seem to suggest greater
           | immunity from the vaccine.
           | 
           | https://directorsblog.nih.gov/2021/06/22/how-immunity-
           | genera...
        
             | [deleted]
        
           | daveguy wrote:
           | Identifying the relative effects of two courses of action is
           | nowhere near a straw man.
           | 
           | Merriam-Webster definition of straw man: a weak or imaginary
           | opposition (such as an argument or adversary) set up only to
           | be easily confuted
           | 
           | Stating the actual side-effects of one course over the other
           | is neither weak nor imaginary.
        
             | Izkata wrote:
             | There are two different buckets of people that OP is
             | conflating:
             | 
             | * Those who haven't been infected yet
             | 
             | * Those who have already been infected
             | 
             | They're ignoring the second bucket, which is what GP was
             | pointing out - only talking about the first bucket and
             | pretending it applies to both.
        
               | daveguy wrote:
               | No. They are addressing the subgroup of the first group
               | of people, who you are ignoring:
               | 
               | * Those who haven't been infected who are wondering if
               | they should not bother with the vaccine if getting
               | infected provides durable immunity.
               | 
               | The answer to that is: the vaccine is orders of magnitude
               | less dangerous than contracting the virus.
               | 
               | Just because you don't address every single group of
               | people in a response does not mean that response is
               | invalid or unimportant.
        
               | briefcomment wrote:
               | What group two should do is far more interesting IMO
               | given this evidence.
        
           | eightysixfour wrote:
           | This study shows that those who have had COVID but are
           | unvaccinated have 2.3x the risk of reinfection compared to
           | those who had COVID and are vaccinated. 246 patients, 492
           | controls.
           | 
           | https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=mm.
           | ..
        
             | rubatuga wrote:
             | This isn't a randomized control trial, meaning you have
             | tons of confounders.
        
             | Izkata wrote:
             | > First, reinfection was not confirmed through whole genome
             | sequencing, which would be necessary to definitively prove
             | that the reinfection was caused from a distinct virus
             | relative to the first infection.
             | 
             | I guess that would explain how it doesn't fit with this: ht
             | tps://bnonews.com/index.php/2020/08/covid-19-reinfection-t.
             | .. (<200 confirmed reinfections worldwide, 82k suspected
             | reinfections worldwide).
        
         | ClumsyPilot wrote:
         | Well unfortunately COVID forgot to ask my opinion before
         | gifting me with one for free
        
           | mbgerring wrote:
           | I'm sorry you got sick, and I'm glad to see this study
           | suggesting you have durable immunity! I worry that since it's
           | dated July 14 it may not have enough data on the Delta
           | variant to be useful in considering your risk going forward.
           | I hope you remain in good health.
        
             | anonuser123456 wrote:
             | The immunity acquired from infection may be more robust
             | against variants since a broader set of antibodies are
             | produced.
        
               | tchalla wrote:
               | May be not.
               | 
               | > The new evidence shows that protective antibodies
               | generated in response to an mRNA vaccine will target a
               | broader range of SARS-CoV-2 variants carrying "single
               | letter" changes in a key portion of their spike protein
               | compared to antibodies acquired from an infection.
               | 
               | https://directorsblog.nih.gov/2021/06/22/how-immunity-
               | genera...
        
               | acituan wrote:
               | You can't compare a longitudinal study with a cross
               | sectional study. This study doesn't account for the time
               | dependent decay of vaccines' immunity. There is more than
               | one dimension to optimize for.
        
               | mikem170 wrote:
               | Same source you quoted also says:
               | 
               | >Our findings show that most COVID-19 patients induce a
               | wide-ranging immune defense against SARS-CoV-2 infection,
               | encompassing antibodies and memory B cells recognizing
               | both the RBD and other regions of the spike, broadly-
               | specific and polyfunctional CD4+ T cells, and
               | polyfunctional CD8+ T cells.
               | 
               | Meaning that natural immunity may be better, because it
               | targets not just the spike protein like the vaccine, but
               | also other parts of the virus.
        
               | jjtheblunt wrote:
               | right : the article points out CD* killer cells target
               | shared across variants nucleotide protein sequences,
               | which the vaccines don't?
        
               | _Microft wrote:
               | A broader set of antibodies does not necessarily have to
               | be beneficial. They might be targeting parts of the virus
               | that could change without it losing its function. The
               | spike protein seems to be close to indispensable for this
               | virus. Targetting it specifically instead of just
               | 'something', might therefore be the preferable thing.
        
               | anonuser123456 wrote:
               | Right, but it is harder for an organism to make multiple
               | adaptations at once. Natural infection produces
               | antibodies that target the spike protein as well as other
               | sites. To evade immunity, the virus would need to change
               | both sites.
               | 
               | It is very clear that the vaccine is putting selective
               | pressure on spike protein evolution. Having alternative
               | targets makes it harder to escape.
               | 
               | We currently don't know if those other sites are
               | beneficial or not. Sometimes they can even be counter
               | productive (ADE, but we don't really see that yet?)
        
               | ithkuil wrote:
               | (genuine question) What does prevent us from creating
               | mRNA vaccines that target multiple sites and not only the
               | spike protein?
        
               | raphlinus wrote:
               | https://theconversation.com/covid-vaccines-focus-on-the-
               | spik... is probably relevant to your question. The short
               | answer (this was also discussed recently on TWiV) is that
               | spike is the earliest interaction with cells, so focusing
               | on it hopefully causes the immune response to mount
               | earlier as well. But, as described in the link, other
               | proteins may be viable targets as well.
        
               | anonuser123456 wrote:
               | Another issue is, other targets may not provide
               | neutralizing immunity and may facilitate ADE. I don't
               | think we've seen ADE in natural infection yet, so it may
               | just be a theoretical issue, but I also don't know if
               | we've really looked for ADE in natural infection either.
               | 
               | We do know that other similar coronavirus vaccine
               | candidates (a candidate for SARS-COV-1) exhibited ADE in
               | primate studies. So since the spike protein appears
               | effective currently, maybe it's best to stick with that.
        
               | raphlinus wrote:
               | For people curious about ADE (a fascinating topic that so
               | far doesn't seem to have caused problems with SARS-
               | CoV-2), here is some excellent background reading that
               | covers many of the points made in the above comment, with
               | citations and deeper discussion:
               | 
               | https://blogs.sciencemag.org/pipeline/archives/2021/02/12
               | /an...
        
               | anonuser123456 wrote:
               | I remember when this whole thing originally broke out,
               | ADE was my biggest fear. Even when China was talking
               | about a 2-3% infection fatality rate, it's like ok.. well
               | that's not going to shatter society. But ADE... the
               | prospect that getting it a 2nd time would raise the IFR
               | to who knows... 20+%? That was scary.
        
       | mensetmanusman wrote:
       | If having COVID imparts as much future protection as the J&J
       | vaccine, there is an ethical argument that one could make:
       | 
       | help vaccinate the poor who want it instead of adding to the
       | asymptotic protection of the rich. Else, people might argue we
       | should all have n- booster shots to get even better protection,
       | when we still don't have enough for the entire world. Vaccines
       | are currently zero sum.
        
       | wpasc wrote:
       | Can any of the findings from the properties of how natural
       | immunity works be guided in to future COVID 19 vaccines?
       | 
       | Given how the pharma companies are examining anti-body half life,
       | exploring booster shots, and considering vaccinations against
       | variants (like lambda), can any of the learnings go into a more
       | durable, more broad vaccine?
        
         | hprotagonist wrote:
         | https://www.nature.com/articles/s41586-021-03738-2
         | 
         | did it already.
        
           | briefcomment wrote:
           | I think GP is referring to the fact that boosters are being
           | pushed, which implies vaccine immunity is not persistent. It
           | has certainly been pushed since when that study was
           | published.
        
             | hprotagonist wrote:
             | we still need the primary antibody count up high, because
             | we're still in a pandemic, thus the desire for boosters.
             | 
             | in both vaccine induced and survivor induced immune
             | responses, long term immune systems come online to store a
             | memory of the disease so that on future challenge, more of
             | those antibodies will be produced by people fairly rapidly
             | after future exposure, even when your blood stream isn't
             | full of covid antibodies anymore.
             | 
             | When there are this many cases floating around, though, you
             | can't afford to wait for the spin-up time.
             | 
             | If i'm asking for the same image every 500ms from your
             | webserver, do you want to go to disk every damn time, or
             | are you gonna cache it? Same deal, kinda.
        
               | nickthemagicman wrote:
               | Anitbodies fade after several months.
               | 
               | The booster shots are being touted for every 12 months or
               | so.
               | 
               | Not sure your statement tracks.
        
               | hprotagonist wrote:
               | don't conflate primary antibodies with b-cells.
               | 
               | You and I aren't walking around with bloodstreams full of
               | anti-measles antibodies, despite being vaccinated in
               | infancy: but you can bet that you will be if you
               | encounter a bunch of measles in the wild, in relatively
               | short order.
               | 
               | The question is: are the covid vaccines like tetanus
               | vaccines or like measles vaccines? So far, the evidence
               | points to the latter, but the desire for a booster anyway
               | is driven by the fact that SARS-CoV-2 is a pandemic;
               | neither tetanus nor measles are.
        
         | ajross wrote:
         | Vaccine immunity _IS_ "natural" immunity. It works the same
         | way, by exposing the body's immune system to virus components
         | such that they product a response. The only difference is that
         | with a vaccine those components don't add up to a viable
         | organism.
         | 
         | But yes: expect newer vaccines tailored to currently-
         | circulating strains to appear; the existing mRNA vaccines
         | produce copies of the spike protein sequenced more than a year
         | ago. That's what we've done for influenza for decades, though
         | not with the same kind of precision.
        
           | kfprt wrote:
           | It's not quite the same, delivery
           | (mechanism/location/encapsulation) is different.
        
           | JimBlackwood wrote:
           | Sure, but there is a real difference in response between
           | vaccine/virus.
           | 
           | I think, given the difference in response, the term natural
           | immunity makes sense. You have to choose something and I
           | don't think 'natural immunity' says anything about vaccine
           | immunity being unnatural.
        
           | nickthemagicman wrote:
           | How is an mRNA strand that encode for a single very specific
           | protein on a virus the same as the entire virus?
           | 
           | The antibody memory made from a Natural Infection seems like
           | it would be much richer and have much more variety than the
           | mRNA vaccine.
           | 
           | I would imagine the attenuated virus vaccine would be closer
           | to Natural immunity.
        
             | Buttons840 wrote:
             | Your body might accidentally create an immunity to a
             | portion of the virus that mutates. Perhaps the protein
             | produced by vaccine mRNA forces your body to create an
             | immunity against a portion of the virus that is less likely
             | to mutate.
             | 
             | I don't know if this is the case, but I offer this as an
             | example of how our biological systems may be complicated
             | beyond intuition.
        
           | User23 wrote:
           | The Red Cross disagrees[1]: "One of the Red Cross
           | requirements for plasma from routine blood and platelet
           | donations that test positive for high-levels of antibodies to
           | be used as convalescent plasma is that it must be from a
           | donor that has not received a COVID-19 vaccine. This is to
           | ensure that antibodies collected from donors have sufficient
           | antibodies directly related to their immune response to a
           | COVID-19 infection and not just the vaccine, as antibodies
           | from an infection and antibodies from a vaccine are not the
           | same."
           | 
           | Interestingly this means if you have natural immunity and are
           | a regular blood donor you shouldn't get the vaccine since it
           | deprives the healthcare system of a lifesaving treatment.
           | 
           | [1] https://www.redcrossblood.org/donate-
           | blood/dlp/coronavirus--...
        
             | maxerickson wrote:
             | They are following the FDA guidance for the convalescent
             | plasma EUA, which does allow people that were sick prior to
             | vaccination to donate plasma...it seems the Red Cross isn't
             | interested in trying to communicate that to potential
             | donors.
             | 
             | https://www.fda.gov/media/136798/download
             | 
             | If you expand the boxes on your link, you'll also see that
             | they aren't specifically collecting convalescent plasma, as
             | demand has decreased. Perhaps that is changing with the
             | recent uptick (but given the demographics of blood
             | donation, they'll probably have to change their rules if
             | they need a lot of it; most people donate ~1 time).
        
           | chuinard wrote:
           | Damn you got downvoted real quick.
        
       | csours wrote:
       | Just a note to non-immunologists - Immunity means different
       | things to health and science professionals vs the general public.
       | 
       | Edit: I'm not going into detail in this comment because I am not
       | an immunologist and I cannot express clearly and correctly what
       | the difference is, but just be aware that "Immunity" may not mean
       | 100% protection in the way that the general public thinks that
       | word means.
        
         | nickthemagicman wrote:
         | As a person with a biology degree who took several immunology
         | courses.
         | 
         | I'd be curious to see what your various definitions are.
        
         | umanwizard wrote:
         | Don't leave us hanging - what does it mean?
        
           | not2b wrote:
           | If I understand correctly, it means that the immune system
           | launches an immediate response to the new infection, it
           | doesn't mean that the immune system successfully defeats the
           | new infection, just makes it more likely. And then there's
           | the problem of variants.
        
           | URSpider94 wrote:
           | I'm still learning, but the concept of "sterilizing immunity"
           | has started to come up recently. What I infer from cursory
           | reading is that "immunity" means the body will mount an
           | immune response immediately upon exposure to the virus, but
           | it doesn't mean that an infection won't take hold.
           | "Sterilizing immunity" means immunity strong enough to
           | prevent the virus from growing at all.
           | 
           | The issue at hand is that those who have been vaccinated
           | and/or recovered from COVID seem to be able to contract the
           | disease again, even to the point where they can be infectious
           | to others, even if they don't get terribly ill or even show
           | symptoms.
        
           | csours wrote:
           | Sorry this is incomplete, but "Natural Immunity" means a
           | person's immune system will mount an effective response to an
           | infectious agent. However, that person may still be infected,
           | and may be contagious to some degree while the body is
           | fighting off the contagion.
           | 
           | I'm not a doctor or biologist, but I've been learning over
           | the past year. For instance, people generally think of things
           | like "infected", "sick", and "contagious" as being the same
           | thing (or nearly the same thing). If you're talking about one
           | person in everyday context, that's fine. If you're talking in
           | a clinical or epidemiological context, you have to be more
           | careful.
        
             | jjtheblunt wrote:
             | A simple example is a person with antibodies being sneezed
             | on with infectious agents. That person could coincidentally
             | sneeze on another person who lacks antibodies, but wouldn't
             | worsen themselves since the contagion in the original
             | sneeze would get met with prepared antibodies killing off
             | the "population" faster than it could replicate.
        
       | andy_ppp wrote:
       | I wonder if having had different less deadly coronaviruses also
       | gives some immunity?
        
         | randymercury wrote:
         | That was a theory around why certain countries have fared
         | relatively well, places like Cambodia and Vietnam.
         | 
         | Their populations could have been exposed to similar viruses
         | and would have had some built in immunity.
        
         | rpmisms wrote:
         | I saw someone citing this a few days ago: having had the common
         | cold recently can lessen your covid symptoms. He didn't source
         | it, but on its face, it seems to make sense.
        
       | rossdavidh wrote:
       | ...more or less like most infections, as has been known for
       | centuries. And yet, due to the current "anything which doesn't
       | make people more fearful must be suppressed" attitude, this kind
       | of thing is news. Or would be, if the U.S. newsmedia were willing
       | to report it, which I suspect they will not.
        
         | BrianOnHN wrote:
         | Is this offering anything more substantive than you own bias
         | and suspicions?
         | 
         | Is there any response that could get you to consider that the
         | comment "anything which doesn't make people more fearful must
         | be suppressed" is as harmful or even more harmful than the
         | media itself?
         | 
         | Asking because I'd like to better understand how to address
         | people with your beliefs in the future.
        
           | mikem170 wrote:
           | Not the poster you are replying to, but I'll bite, out of
           | curiosity about your thinking...
           | 
           | > Is this offering anything more substantive than you own
           | bias and suspicions?
           | 
           | My take-away from the article is that they found all the bits
           | of the immune system primed for long term protection after
           | covid infections. Which is not entirely unexpected, this is
           | what happens with sars, also.
           | 
           | > Is there any response that could get you to consider that
           | the comment "anything which doesn't make people more fearful
           | must be suppressed" is as harmful or even more harmful than
           | the media itself?
           | 
           | I got pretty fed up the news other day when the front page of
           | the BBC led with the an article about leaked CNN memo and
           | three unnamed employees who were fired for not getting
           | vaccinated, and another about Jennifer Aniston apparently
           | cutting off contact with unvaccinated friends. I felt
           | manipulated. I consider stuff like this to be propaganda, not
           | news. It reminded me that I need better sources for covid
           | information, like statnews.com, to get away from such things.
           | 
           | I'd rather see more facts and less adjectives in the news.
           | I'd rather that politicians justify their actions based on
           | numbers, not vague statements. It doesn't seem like the
           | general public is trusted with the facts, but are rather fed
           | a lot of alarmist information.
           | 
           | I imagine the parent poster's assumption is that it would be
           | front page if this study said that natural immunity expires
           | quickly, but we won't see this good news about long lasting
           | immunity on the front page.
        
       | dang wrote:
       | All: I know it's an activating topic, but this thread has tons of
       | comments breaking the site guidelines. That's not ok.
       | 
       | If you're going to comment, make sure you know the rules and
       | stick to them: https://news.ycombinator.com/newsguidelines.html.
       | That means making substantive points thoughtfully.
       | 
       | If you want to put down or yell at people on the other side of
       | this $hot-topic, or any topic, please do that somewhere else.
       | We're trying for a little better than internet default here.
        
       | hprotagonist wrote:
       | https://www.nature.com/articles/s41586-021-03738-2
       | 
       | vaccines also produce durable and persistent immune responses.
       | Primary antibody titers wane, but the system itself remembers and
       | can regenerate them when challenged.
       | 
       | see https://news.ycombinator.com/item?id=28107714 for contra "but
       | muh boosters", which i suspect is what's helping me collect
       | downvotes.
        
         | orbifold wrote:
         | Not really the anti-body count decays more quickly compared to
         | that of a natural infection and does so dramatically especially
         | for older people: https://www.thelancet.com/journals/lancet/art
         | icle/PIIS0140-6.... This is the underlying reason that there is
         | talk of boosters.
        
           | rcpt wrote:
           | Older people has to have some sample bias since those without
           | strong immune systems died.
        
           | Valgrim wrote:
           | It is normal for antibodies to decline after an immune
           | response, it doesn't mean the immunity is gone, the immune
           | system remembers how to produce them when needed.
           | 
           | The paper you link actually says that the memory B-cell
           | populations appear to be maintained after the waning of the
           | antibodies. B-cells are the cells that remembers and creates
           | antibodies in response to an antigen (like the spike protein
           | on the surface of the virus).
        
         | nickthemagicman wrote:
         | Natural immunity may work better considering the vaccine
         | requires booster shots every 12 months according to the Pfizer
         | CEO.
         | 
         | https://www.cnbc.com/2021/04/15/pfizer-ceo-says-third-covid-...
        
           | Valgrim wrote:
           | The requirement for booster shots may be for increasing
           | immunity to variants, not the original virus. If you survived
           | the original virus and got an immunity out of it you are just
           | as vulnerable to variants as anyone who got the vaccine.
           | 
           | Basically, subsequent shots are security updates.
        
         | keneda7 wrote:
         | Please stop spreading misinformation. IMO 15 weeks is not long
         | enough to determine if its durable and persistent. There would
         | be no talk of booster shots if what your saying is true.
        
           | hprotagonist wrote:
           | not so, see my other thread in this story here, and cool it
           | on the personal attacks, thanks!
           | 
           | https://news.ycombinator.com/item?id=28107714
        
             | keneda7 wrote:
             | I updated my comment to make it less personal. Sorry about
             | that
        
           | JimBlackwood wrote:
           | Bit of an overreaction. Stating that the testing period of 15
           | weeks is, in your opinion, too short to determine long-term
           | immunity would've sufficed as comment.
           | 
           | No need to be uncivil to eachother when you don't agree.
        
             | keneda7 wrote:
             | Updated the comment.
        
         | artursapek wrote:
         | Why are you trolling this thread and shilling vaccines? Does
         | the sight of people discussing the wonder of our natural immune
         | system bother you?
        
           | bitexploder wrote:
           | No one is shilling vaccines. We use the "wonder of our
           | natural immune system" effectively with the vaccine without
           | being a public health risk to everyone around us by skipping
           | it.
        
             | iamadog129038 wrote:
             | Interestingly, we're putting unnatural selection pressure
             | on the viruses by leveraging vaccines that are leaky, this
             | has in at least one example been shown to produce a
             | deadlier pathogen for unvaccinated. So, maybe you had ought
             | to be a little more skeptical about your risk assessments
             | when the data isn't yet in and may never be until it is.
             | And as for the philosophical conundrum, I'd posit that it's
             | far safer to maintain the known function than it is the
             | novel, keep the defaults. We've of course more or less
             | crossed the Rubicon.
             | 
             | https://www.nationalgeographic.com/science/article/leaky-
             | vac...
        
               | pixl97 wrote:
               | This is a pretty bad take. No vaccine has 100% coverage.
               | Most of the time we're talking about 85-90% protection
               | rate, with some low possibility of mild infectious
               | contagion.
               | 
               | The particularly ignorant take on your part is ignoring
               | 1918 to 1919 change in that flu. It 'naturally' became
               | far more deadly with no vaccine needed.
        
               | bitexploder wrote:
               | Right. Abstractly viruses find a sweet spot between
               | transmission rate and lethality to host. Too lethal and
               | it won't spread very far. However, in practical terms
               | there is a lot more room for something like COVID to be
               | far more damaging and still spread just like it has been
               | or more. All of the immunity we now have and the
               | particular nature and quality of it will certainly impact
               | what the virus does when mutating. If it really can
               | breakthrough vaccinated populations it's going to change
               | how it evolves. That is a lot of ifs, buts and maybes.
               | The real world data just is t backing up a lot of these
               | weak claims folks are making. In practical terms the
               | vaccines work and do their job. There is a lot of
               | interesting observations to make and we are in the middle
               | of a great experiment of sorts, so we should be very data
               | driven in my opinion.
        
               | pixl97 wrote:
               | In some ways I wonder how much randomness is involved.
               | That the error bars involved in any particular virus is
               | very large.
        
       | DantesKite wrote:
       | I could see a case to vaccinate people even if they have natural,
       | durable, and long-lasting immunity to Covid-19 after infection if
       | it makes their immunity even stronger.
        
       | YPCrumble wrote:
       | If twenty percent of the population has had covid, and fifty
       | percent has been vaccinated, say we assume half of the twenty
       | percent isn't an overlap. Wouldn't that put us much closer to the
       | herd immunity number of seventy percent than we've been thinking?
       | And that if infections continue at a high pace, shouldn't we
       | reach that level very soon?
        
         | raphlinus wrote:
         | The idea of being at or near herd immunity has been pushed so
         | many times since the start of this pandemic, and each time
         | those hopes have been dashed.
         | 
         | The threshold needed for herd immunity has been revised upward
         | since the 70% figure was widely discussed. First, the R0 for
         | the delta variant is almost certainly higher than for earlier
         | variants. I am personally skeptical of claims in the 8 range,
         | but they are widespread, especially by public health
         | professionals, in contrast to, say, virologists, who tend to
         | point to antigenic drift as a mechanism that could explain the
         | rise in delta prevalence.
         | 
         | Also, vaccine effectiveness is a factor in the herd immunity
         | threshold, and that is also reduced a bit off earlier high
         | estimates, partly because of variants and partly because of
         | antibody waning.
         | 
         | So my best guess is that herd immunity is now permanently out
         | of reach. I'd love to be proved wrong on that, though.
        
       | 015a wrote:
       | Its important to keep studies like this in mind when talking with
       | people who refuse to take the vaccine because they "already had
       | COVID". In a very real sense, if natural antibodies are durable,
       | persistent, and effective; the vaccine is an unnecessary medical
       | procedure. Doctors would not cut off your legs for no reason;
       | that would be unethical. The vaccine is a medical procedure like
       | any other; if the benefit is questionable, it would be unethical
       | for doctors to administer it.
       | 
       | Yet, we have an increasing number of venues, workplaces, and
       | events which are requiring proof of vaccination to participate.
       | This is forcing both people who already have antibodies, and even
       | people who can't make antibodies (e.g. immunocompromised, solid
       | organ transplant, etc), to undergo a medical procedure for little
       | to no benefit.
       | 
       | Primum non nocere
        
         | mxxc wrote:
         | it is a scandal, especially considering the amount of non-
         | immunised people at risk in the rest of the world. i fall in
         | that category (recovered) and i would even pay to give my
         | vaccines away.
        
           | Hashemm wrote:
           | Didn't realize anti-vaxxers would be on this site...
        
             | [deleted]
        
             | rantwasp wrote:
             | they are everywhere. they have facebook phds in vaccines
             | and public health along with a masters in selection bias.
        
           | kiba wrote:
           | It is not being used by people who should get said vaccine
           | here in the states, and it is questionable if we even have
           | the logistics to enable it.
           | 
           | I supposed even if the logistics is questionable, we should
           | try to distribute it to people who are actually going to use
           | it.
        
         | IAmGraydon wrote:
         | Comparing it to an amputation is beyond ridiculous. If you have
         | to make leaps of logic like this, you know your argument is
         | extremely weak.
        
           | briefcomment wrote:
           | Ok, doctors would not administer steroids for long term use
           | for minor pain, that would be unethical and highly dangerous
           | (except they do, from first hand experience)
        
             | BrianOnHN wrote:
             | Or prescribe antibiotics for potentially viral infections
             | (they do...)
        
             | bradleyy wrote:
             | This is the tu quoque logical fallacy.
        
           | 015a wrote:
           | You're right; its a ridiculous comparison.
           | 
           | The risks of amputation are relatively well-known and
           | understood.
           | 
           | The risks, especially long-term, of mass, imperfect
           | vaccination, using an entirely brand new development
           | technology; not well known. Not understood. Are there long-
           | term, rare side-effects of the vaccine we don't know about?
           | Will the imperfect nature of the vaccine and its rollout
           | cause wider evolution of vaccine-resistant coronaviruses? We
           | don't know.
           | 
           | Its a ridiculous comparison because one of these things is
           | dangerous; the other has unquantified risk.
           | 
           | That's why "First, Do No Harm" is such an important
           | foundation of medical ethics. We are dealing with systems
           | more complex than you can even imagine; between the human
           | body, multi-human interactions, and planet-scale resource
           | allocation during a pandemic. There is a LOT we don't know.
           | 
           | This doesn't mean you shouldn't get vaccinated. I have. Many
           | people should. The benefits are well-known and understood;
           | they're pretty strong. But it does mean, maybe there's a
           | middleground we need to find which doesn't involve demonizing
           | and ostracizing the people who choose not to. We should be
           | better at understanding each-other, and understanding how
           | dangerous unknown risks can be, especially when we're put
           | into a position of making decisions out of fear.
        
         | pfisherman wrote:
         | I think other comments may have pointed this out already, but
         | there are several problems with this line of reasoning.
         | 
         | When deciding on whether or not to administer a procedure or
         | treatment, one must consider the balance of potential harms and
         | benefits, while accounting for uncertainty.
         | 
         | In this particular case, the potential for harm from the
         | vaccine is quite low (this is borne out by the data), and the
         | benefits are mostly unknown. The potential harms of NOT taking
         | the vaccine are mostly unknown (data is still coming in), and
         | the potential benefit of that course of action is quite low. So
         | it seems like the positive expected value / utility decision
         | here is for them to get the vaccine.
         | 
         | In your comment you use the analogy of a procedure with a much
         | different risk / benefit profile. So that does not really hold
         | up. A much better analogy would be something like routine
         | screening for prostate cancer once you pass a certain age.
        
           | Retric wrote:
           | This line of thinking assumes you can reliably separate
           | people that have had covid from those that haven't. In the
           | real world requiring vaccines for everyone means vaccination
           | of people that thought they had covid but didn't.
           | 
           | Which I suspect may be the underlying reason studies are
           | showing the vaccines are more effective than getting covid.
        
           | ithkuil wrote:
           | > In this particular case, the potential for harm from the
           | vaccine is quite low (this is borne out by the data),
           | 
           | Which is why a common anti-vax argument is sow doubt about
           | the harmful effects.
           | 
           | I noticed a few options:
           | 
           | a) conspiratorial: "the government is lying about side harm"
           | 
           | b) anecdotal: "I personally know at least 3 people who
           | couldn't walk after the vaccine. Do you call me a liar?"
           | 
           | c) hyper-skepticism: "how can we know if it long term side
           | effect? Yes it's proven safe for X months, but what about in
           | Y month? what about Y years?"
           | 
           | I found it hard to defuse such positions with "just more
           | data". They seem to be memes (crafted or just evolved?) that
           | resist quite strongly to data.
        
             | peteradio wrote:
             | It seems to me very reasonable to worry about long-term
             | outcomes when we are talking about vaccinating every man
             | woman child. Maybe its got precedence but damn if its not
             | worrying, and honest skepticism ought to be treated with
             | respect not derided.
        
               | ithkuil wrote:
               | I'm not deriding the honest worry. Nobody can know with
               | certainty anything about the future.
               | 
               | I'm worrying about the paralyzing effects of a meme that
               | says that since it's technically possible for an adverse
               | affect to happen at an arbitrary point in the future, we
               | cannot consider an option to curb the effects of a known
               | problem we have right now.
               | 
               | Often I'm accused of dismissing the possibility of
               | adverse effects like if I knew with certainty that they
               | can't happen. How could I? Nobody knows. That's not the
               | point. The point is to make a guess and take balanced
               | risks. We take risks all the time, about everything.
               | 
               | What's so special about vaccines that causes such
               | widespread reaction? Is it because people feel forced to
               | take them? Is it something about the way they work that
               | triggers such a reaction in people that often
               | (anecdotally) don't care about things like effects of
               | second hand smoke?
               | 
               | (Genuine questions)
        
               | peteradio wrote:
               | I will try to answer your questions from my point of
               | view.
               | 
               | It appears "off" that there is no nuance to this
               | vaccination strategy. It seems especially odd to advocate
               | for vaccinating children who stand to benefit very little
               | personally. I had planned to get vaccinated but have been
               | pretty concerned by the totalitarian vibes I've been
               | getting lately. So I guess I've decided to let my civics
               | slide to match. I will get the vaccine for my own
               | personal benefit (if I deem it so) and I expect that is
               | basically what's motivated everyone else anyway. So far
               | I've not seen a clear benefit to me. According to this
               | page https://19andme.covid19.mathematica.org/ these are
               | my stats:
               | 
               | "probability of catching COVID-19 through community
               | transmission in a week is 0.027%" "If you get sick from
               | COVID-19, the risk of hospitalization is 1.3% , the risk
               | of requiring an ICU is 0.67% , and the risk of not
               | surviving is 0.053%"
               | 
               | If I tell the calculator I'm vaccinated then most those
               | stats go down by 2 which is good but my threshold for
               | action is on an absolute scale and staying unvaccinated
               | does not trip the sensor.
               | 
               | I choose to live life in rural America in some part to
               | avoid such calamities. As an unvaccinated person I am
               | less of a risk to other people person than a vaccinated
               | person in da big city.
               | 
               | To me personally the main issue has little to do with
               | vaccines and more to do with frankly unnecessary (in some
               | cases) overreach. I'm not saying overreach has happened
               | already, but recent overtures are quite alarming to me.
        
               | ithkuil wrote:
               | What would be your risk threshold (hypothetically
               | speaking, if we could know it) that would make it for you
               | a no-brainer to just take the vaccine assuming that you
               | taking it would encourage other people who do fall in a
               | higher risk bracket to also take it?
               | 
               | Would 0.0001% risk be acceptable for you, hypothetically,
               | as a civic duty?
        
               | peteradio wrote:
               | I'm not even assessing the risk of the vaccine in my
               | judgement.
               | 
               | I'm saying the apparent _risk of the disease_ to myself
               | and from me to others is not above the necessary level to
               | stir an action from me.
               | 
               | I'm probably going to get the vaccine if I see some sense
               | of nuance to the guidance. Such as reasonable advice
               | properly and publicly discussing the relative
               | risk/rewards for our various demographics. The current
               | attitude that I'm confronted with in my day-to-day is
               | "wow what a dumb fuck hes hurting himself and everyone
               | around him", _for me_ the stats say otherwise.
        
               | ithkuil wrote:
               | I'm pulling a different angle into the equation: an
               | altruistic angle. Are you a priori not interested in
               | participating in an effort that would require an action
               | from you (and possibly also a risk) unless you're
               | directly beneficiary of such action?
        
               | peteradio wrote:
               | I'd assert that in such an experiment I would already be
               | doing my part to reduce the impact of covid mainly due to
               | where I live and minorly by my choices of how I live. The
               | extra utility of that vaccine is effectively lost on me
               | when that is figured in. When there is 0 utility then any
               | altruistic action is nothing more than signaling. If I
               | could be convinced there is serious utility for others by
               | getting vaccinated then of course I would get it. Nobody
               | seems willing to put real numbers to this, its simply "DO
               | IT EVERYONE!"
               | 
               | Lets say there are only 2 reasons to get the vaccine:
               | 
               | 1) To protect yourself
               | 
               | 2) To protect all those you care for.
               | 
               | I'm not worried about 1 due to the apparently very low
               | likelihood I will have some terrible personal covid
               | outcome.
               | 
               | I'm not worried about 2 due to the apparent very low
               | likelihood of even catching covid.
        
               | pfisherman wrote:
               | Reasonable skepticism should not be derided. But I would
               | say (a) the skepticism is borderline, and (b) poor
               | decision making is what is being derided.
               | 
               | So why is the skepticism borderline? Well we have over
               | 100 years of data showing that vaccines I'm general are
               | safe and effective. The safety and effectiveness of
               | vaccines has drastically improved during that century -
               | especially in the last 20 years. mRNA vaccines is a new
               | platform, but all the preclinical and clinical data tee
               | have shows they are safe and effective, and if we were
               | going to see long term effects (which would be related to
               | abnormal inflammatory / immune) response; it is highly
               | likely we would have seen some indicator by now. Which
               | specific long term effects are people even worried about?
               | 
               | And this brings us to why it is a poor decision. SARS-
               | COV2 rewires your innate immune response, and has been
               | observed to cause abnormal inflammatory/ immune responses
               | that cause to death and long term disability with
               | alarming frequency. So it seems like extremely poor
               | judgement to be worried about long term effects from the
               | vaccine more than the virus. The first concern is largely
               | unsupported by the data, while the second is
               | unquestionably supported by the data.
        
               | ithkuil wrote:
               | Yes we have plenty of data about past vaccines:
               | 
               | https://www.chop.edu/news/long-term-side-effects-
               | covid-19-va...
               | 
               | "The history of vaccines shows that delayed effects
               | following vaccination can occur. But when they do, these
               | effects tend to happen within two months of vaccination:
               | ...<some examples>"
               | 
               | Whenever I show this kind of info to my family/friends
               | that are against vaccines the response follow the three
               | categories I posted earlier above.
               | 
               | I categorically do not want to make fun of anybody. I
               | really want to understand either:
               | 
               | a) what's wrong about my understanding of the safety of
               | this vaccination campaign (i.e. can really the world
               | governments conspire so efficiently to hide the real
               | data, or other arguments above)
               | 
               | Or is it just a big identity politics problem, where we
               | all think we engage in a rational discussion while each
               | of us has already taken a stance that we cannot be moved
               | out with arguments? (I'm putting myself into question
               | too)
               | 
               | b) how can I understand and reach my family members and
               | friends and engage in a discussion that is not shut off
               | quickly by one of the aforementioned unfalsifiable
               | positions
        
         | mercora wrote:
         | how easy is it to test for these antibodies for a layman? could
         | people actually easily get tested prior to considering a
         | vaccination?
        
           | landemva wrote:
           | In my experience, the finger prick blood test cost $25 and 15
           | minutes. This test is for blood antibodies. This is not the
           | test for active infection, such as nasal PCR.
        
           | 542458 wrote:
           | The test is easy, but has a relatively high false positive
           | rate. It also may use up lab resources that could be put to
           | other uses.
           | 
           | The other wrinkle (and possibly the most important one) is
           | that we don't want to create a system where antivaxxers have
           | an incentive to deliberately infect themselves and/or others.
        
             | krona wrote:
             | > _The test is easy, but has a relatively high false
             | positive rate._
             | 
             |  _The FDA approved Roche serology test has a specificity
             | greater than 99.8% and sensitivity of 100% (14 Days post-
             | PCR confirmation)_
             | https://www.roche.com/media/releases/med-cor-2020-05-03.htm
             | 
             | I wouldn't say 0.02% is a particularly high FP rate.
        
               | rubatuga wrote:
               | I think GP is saying that people who are no longer sick
               | or infected, such as a month later, show false lositives
        
               | 542458 wrote:
               | I was under the impressing that the Roche test was an
               | outlier, and that most other tests do not match that.
               | Most other tests have issues with cross reactivity with
               | common cold antibodies.
        
           | briefcomment wrote:
           | It's available and getting cheaper pretty quickly. Hopefully
           | others can chime in, seems like a promising path to take.
        
           | lazyjones wrote:
           | There are commercially available antibody tests that can
           | distinguish between antibodies from natural infection and
           | from the common vaccines.
           | 
           | https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/anti.
           | ..
           | 
           | > _The first vaccines distributed in the United States induce
           | antibodies to S protein. Thus, presence of antibodies to N
           | protein indicates previous natural infection regardless of
           | vaccination status, while presence of antibodies to S protein
           | indicates either previous natural infection or vaccination._
        
         | echelon wrote:
         | The vaccine is less dangerous than flying in an airplane. It
         | can boost your immunity even further. (Every boost to immune
         | recognition, recruitment, and proliferation decreases the odds
         | of infection and spread. You need to understand how the system
         | works, and that takes at least three months of study.)
         | 
         | This anti-science meme is turning us into yelling cavemen.
         | 
         | If you don't understand the science, please educate yourself
         | before speaking out against it.
        
         | deanclatworthy wrote:
         | As far I'm aware this is an American thing. I'm from Finland
         | (no vaccine pass yet) but travelling in Germany/Austria right
         | now. They have the concept of 3G (don't ask me to translate)
         | but basically you can't eat, drink or stay anywhere without
         | either a vaccine, recovery or negative test.
         | 
         | There is a pop up antigen test facility about 100m from the
         | restaurant where anyone can go get a quick negative result and
         | go do their thing for a set period of time. I'm conflicted on
         | this given the inaccuracy of the antigen tests.
         | 
         | I'm currently sat in a restaurant typing this message, and have
         | been served food and drink and yet to be asked to verify my EU
         | certificate of vaccination. So your mileage may vary.
        
           | ithkuil wrote:
           | Most of the pushback I hear here (Italy) about the ability to
           | just get tested as an alternative to vaccine certification is
           | the cost. It's perceived as a tax on the freedom to not
           | vaccinate.
        
             | deanclatworthy wrote:
             | I just looked it up. Where I'm staying the tests are 57e,
             | you do it yourself, and get a result within 20mins which is
             | valid for 24h. That definitely is a high cost.
        
               | mejutoco wrote:
               | Probably as a tourist it is different? I live in Germany
               | and you can get an antigen test for free per day. They
               | are valid for 24 hours, so it costs 0EUR To get tested
               | for any event.
        
             | mmcnl wrote:
             | The cost is not only in money, but also in time, and
             | requiring more upfront planning. Legitimate concern imo.
        
             | [deleted]
        
           | maxerickson wrote:
           | To a first approximation, the American thing is to not have
           | any requirements for entry. There's a few employers and
           | cities departing from that policy.
        
         | treeman79 wrote:
         | I had covid in November. Have had it again the past week and a
         | half. It was a rough time the first time, but not as bad as
         | when I had pneumonia.
         | 
         | Now, A constant mild sore throat and a lot of bad headaches.
         | Otherwise not much.
        
         | raphlinus wrote:
         | I know this thread is catnip for the antivax contingent that
         | reliably appears, but this argument has several problems.
         | 
         | First, our vaccines provide a stronger immune response than
         | infection, as has been well documented by now[1]. Vaccination
         | on top of prior infection boosts the response[2].
         | 
         | Second, the harm from the vaccine is minimal, and comparing it
         | with an amputation is ridiculous (in spite of the large number
         | of superstitious people who believe otherwise).
         | 
         | There are subtle arguments to be made for adjusting vaccination
         | (one shot is almost certainly enough) when prior infection is
         | documented, but from a public health perspective it's simple
         | enough: pretty much everybody (over 12 until trials complete)
         | should get vaccinated, and if they did, illness and death would
         | decrease dramatically.
         | 
         | [1]: https://directorsblog.nih.gov/2021/06/22/how-immunity-
         | genera...
         | 
         | [2]: https://jamanetwork.com/journals/jama/fullarticle/2782139
        
           | blub wrote:
           | I haven't seen almost any comments on HN which can be
           | qualified as anti-vaccine, so I find your assertion
           | unjustified. But the real issue I have with such comments is
           | that now apparently someone that does not want a _specific_
           | medical treatment is being smeared as "antivax".
           | 
           | Rejecting a medical intervention is a right people have. It
           | doesn't matter it's because of 5G, fertility, medical
           | conditions or them merely not being in the mood to take the
           | vaccine.
        
           | Loveaway wrote:
           | No. Stop it. It's not simple enough. Stop this crazy
           | obsession.
           | 
           | Adverse reaction are real. Here's a woman who has had her
           | legs amputated[1] a few days after receiving the second dose
           | of the Pfizer vaccine. Stated cause: she contracted COVID.
           | More cases like it, blood clots, heart inflammation, sudden
           | death. You all know this is happening, don't you?
           | 
           | Close your eyes and sweep it under the rug. Keep ignoring the
           | uncomfortable and unfortunate. Keep dismissing it as minimal
           | harm.
           | 
           | You'd make the Nazis proud. When the Germans committed crimes
           | against humanity the general population simply didn't know
           | about it. They didn't notice millions of people were taken
           | forcefully out of their homes. Rounded up and brought
           | somewhere. Simply no idea what was happening. No of course
           | they knew, they just suppressed it. To protect themselves and
           | their fragile, fear-filled, state of mind.
           | 
           | It sounds drastic, but this is the path you're on. Too
           | committed to this narrative. Unable to evaluate the situation
           | for what it is. The vaccine is not necessary and neither
           | entirely safe. You have been listening to the fear porn for
           | too long. The numbers don't add up, left and right. The
           | reality is much more mundane.
           | 
           | The number of COVID death in China to this day is 4,636 [2].
           | People outside of risk groups have nothing to worry, will
           | experience no to mild symptoms, before acquiring natural
           | lasting immunity. Death rates around the world are barely
           | moving, in many countries dead on average. The studies are
           | worthless, when the larger, population-wide scale tells a
           | different tale. People just aren't dying en masse - there's
           | nothing to support this madness, or inject everybody with
           | spike protein on annual basis, you truly are too daft to
           | realize that? Do you think someone that does not have
           | symptoms of illness, can be considered ill?
           | 
           | Spin it however you want, ignore the inconsistencies, inject
           | yourself with whatever calms your mind, but DO NOT force it
           | onto others and for your own sake DO NOT continue to take
           | booster shots.
           | 
           | [1] https://www.ibtimes.sg/who-jummai-nache-minnesota-womans-
           | bot... [2]
           | https://www.worldometers.info/coronavirus/country/china/
        
             | pcbro141 wrote:
             | Serious question, why should we believe China CCP numbers?
        
             | Natsu wrote:
             | Adverse reactions are real, but they are orders of
             | magnitude less likely than those caused by Covid itself and
             | Covid is capable of causing basically all the same long
             | tail harms the vaccines can.
             | 
             | Which makes sense--many of them are made of some part of
             | the virus, so how can they be more deadly than Covid itself
             | if they're just a piece of it?
             | 
             | It's weird to me that people aren't willing to trade a 2%
             | risk for a 0.0002% risk when both have similar types of
             | horrible outcomes.
        
           | temac wrote:
           | Maybe the comparison with amputation is a little over-the-top
           | but let me illustrate with a few other real-world examples
           | why this kind of concern is not _completely_ illegitimate.
           | 
           | The health policy in some countries e.g. in France (and maybe
           | large parts of Europe?) actually allow you to have an "health
           | passport" just because you recovered from Covid recently
           | enough.
           | 
           | It would actually be illegal in France to privately require
           | proof of vaccination if not exceptionally allowed by a narrow
           | law (as a general principle, medical information are very
           | protected here).
           | 
           |  _Some_ Covid vaccines have been forbidden for people under a
           | specific age limit, although they were allowed for a while,
           | but the risk has eventually been reassessed after a few
           | suspects side effects (very very rare, but considered a risk
           | important enough to change the policy, esp since the risk of
           | covid itself decrease greatly the younger you are, and there
           | are arguably safer alternatives in other models of vaccines).
           | 
           | Of course it is still probably "on average" better to get
           | vaccinated on top of recovering from Covid, and of course the
           | comparison with amputation was probably over-the-top (at the
           | very least it should have been stated as a risk of
           | "amputation" with a very very low proba); but overly
           | constraining people is debatable -- especially when tons of
           | factor are hard to be synthetized to "everybody should just
           | get vaccinated right now, unconditionally, -- and accept to
           | be privately controlled by anybody -- or they are horrible
           | antivax people and people will die because of them"; not
           | everybody has the same amount of social contacts with the
           | same categories of people and/or live in the same kind of
           | city and accommodations, public health is not something that
           | appears in empty social contexts just because of raw numbers
           | and models, etc.
           | 
           | Yes it probably would be better if "everybody" was
           | vaccinated. Willingly. And if we had decades of feedback to
           | convince people. And if they were vaccinated against other
           | diseases too. Now welcome to the real world and think of how
           | to navigate efficiently with imperfect knowledge, including
           | how to avoid _entirely_ dismissing concerns.
           | 
           | Primum non nocere certainly does not to be dropped and
           | hopefully will not: the situation is shitty but will become
           | clearer with time, and if we detect either more risks or more
           | safety for various vaccines hopefully the policies will
           | evolve accordingly, and individual opinions too. Note that
           | they already are not completely binary and that it is still
           | kind of hard to decide from which age we should allow /
           | incite / require vaccination -- and the "optimal" solution
           | probably depends on the coverage of the rest of the
           | population too.
           | 
           | And that's because of that very principle. There is _no exact
           | obvious point_ where all-in starts to be required. It maybe
           | would be useful to make regular-flu shots more or less
           | mandatory (and now even the interest of flu-shots is debated
           | by _serious_ scientists because it may be counter productive
           | for the state of the immune system latter in life; or that
           | may depend on people -- maybe new strains of covid would
           | yield to similar debates in a few years?). They are typically
           | not.
           | 
           | That being said my current understanding make me wish more
           | people go get vaccinated, but just do not pretend it is all
           | black & white and that people should not have subtle/reserved
           | opinions.
        
           | peteradio wrote:
           | [1] is not generally supportive of your very broad statement.
           | You must qualify you statement with some indication of this
           | stated limitation: "carrying "single letter" changes in a key
           | portion of their spike protein"
        
             | raphlinus wrote:
             | It is one datapoint among many, but I found it interesting
             | because it is based on careful biological experimentation
             | and directly compares immune response from vaccination and
             | prior infection. Another relevant quote: "Importantly, the
             | vaccine-elicited antibodies targeted a broader range of
             | places on the RBD than those elicited by natural
             | infection." This is not an intuitively obvious result.
             | 
             | But, since it was asked, here are more studies that support
             | the broader point:
             | 
             | * https://www.contagionlive.com/view/immune-response-from-
             | mrna... describes a study directly addressing the question,
             | and with impressive results.
             | 
             | * https://medicine.wustl.edu/news/covid-19-vaccine-
             | generates-i... didn't directly compare against prior
             | infection, but this is discussed briefly and there is
             | strong support in favor of protection from vaccines.
             | 
             | * https://www.medpagetoday.com/opinion/marty-makary/92434
             | is a discussion with a virologist (not peer reviewed
             | science).
        
               | peteradio wrote:
               | It seems odd to present these tangential measurements
               | when what I think most people are interested in is
               | personal outcomes. How can one relate relative increases
               | in seropositivity to patient outcomes? Why don't we see
               | studies which conclusively nail this down? I'm well aware
               | of this study https://www.cdc.gov/mmwr/volumes/70/wr/pdfs
               | /mm7032e1-H.pdf, I'm unmoved by it, see this comment:
               | https://news.ycombinator.com/item?id=28106987 . Are you
               | aware of more substantial studies to date? Thank you for
               | the links and the discussion. I personally have yet to
               | get the vaccine but do consider myself persuadable.
        
             | _Microft wrote:
             | I couldn't put the quote into context properly, so in case
             | you are also wondering, here is the full quote:
             | 
             |  _" The new evidence shows that protective antibodies
             | generated in response to an mRNA vaccine will target a
             | broader range of SARS-CoV-2 variants carrying "single
             | letter" changes in a key portion of their spike protein
             | compared to antibodies acquired from an infection."_,
             | excerpt from the article
        
               | [deleted]
        
           | criticaltinker wrote:
           | > vaccines provide a stronger immune response than infection
           | 
           | This is a blatant oversimplification & misrepresentation of
           | the article you referenced, and the paper which it cites [1].
           | The paper makes no claims that vaccine induced immune
           | responses are more or less superior than the immune response
           | induced by natural infection.
           | 
           | Quote from [1]:
           | 
           | - "Specifically, antibodies elicited by the mRNA vaccine were
           | more focused to the RBD compared to antibodies elicited by an
           | infection, which more often targeted other portions of the
           | spike protein."
           | 
           | Counterintuitively, this property of the current mRNA
           | vaccines - the induction of an immune response highly
           | targeted toward the spike protein RBD - when combined with
           | compulsory mass vaccination, could result in widespread
           | proliferation of vaccine resistant variants [2][3][4][5].
           | This is a serious concern that is on the radar of many top
           | experts in the field.
           | 
           | The second and third order consequences of mass vaccination
           | using an imperfect vaccine are anything but simple, and very
           | much pose a public health risk.
           | 
           | When you consider the evidence supporting the fact that
           | natural immunity is at least equally effective as vaccination
           | (a few more supporting references here [6][7]), it becomes
           | very difficult to defend the idea you're advocating:
           | 
           | > it's simple enough: pretty much everybody (over 12 until
           | trials complete) should get vaccinated
           | 
           | [1] Antibodies elicited by mRNA-1273 vaccination bind more
           | broadly to the receptor binding domain than do those from
           | SARS-CoV-2 infection
           | https://stm.sciencemag.org/content/13/600/eabi9915
           | 
           | [2] Risk of rapid evolutionary escape from biomedical
           | interventions targeting SARS-CoV-2 spike protein
           | https://pubmed.ncbi.nlm.nih.gov/33909660/
           | 
           | [3] SARS-CoV-2 immune evasion by the B.1.427/B.1.429 variant
           | of concern https://science.sciencemag.org/content/early/2021/
           | 06/30/scie...
           | 
           | [4] mRNA vaccine-elicited antibodies to SARS-CoV-2 and
           | circulating variants
           | https://www.nature.com/articles/s41586-021-03324-6
           | 
           | [5] Imperfect Vaccination Can Enhance the Transmission of
           | Highly Virulent Pathogens https://journals.plos.org/plosbiolo
           | gy/article?id=10.1371%2Fj...
           | 
           | [6] Necessity of COVID-19 vaccination in previously infected
           | individuals https://www.medrxiv.org/content/10.1101/2021.06.0
           | 1.21258176v...
           | 
           | [7] Antibody Responses 8 Months after Asymptomatic or Mild
           | SARS-CoV-2 Infection
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920668/
        
           | dsyrk wrote:
           | Why are you intentionally misleading people with dis-
           | information.
        
         | asddubs wrote:
         | interesting, over here in germany if you (provably) had covid
         | you don't have to get vaccinated to enter places requiring that
         | or a test
        
           | l33tman wrote:
           | I think the EU timeout for the proved infection is 6 months
           | unfortunately. So someone in the EU decided that a COVID
           | infection's protection only lasts 6 months.
        
             | querez wrote:
             | In the absence of long-term studies, isn't it prudent to
             | assume it has a shell-life? And if so, who's to say 6 month
             | isn't a sensible heuristic?
        
         | rvp-x wrote:
         | I am under the impression that a lot of places consider
         | recovered cases as equivalent to fully vaccinated.
        
         | nicoffeine wrote:
         | > In a very real sense, if natural antibodies are durable,
         | persistent, and effective; the vaccine is an unnecessary
         | medical procedure. Doctors would not cut off your legs for no
         | reason; that would be unethical.
         | 
         | Taking a vaccine is not equivalent to cutting off someone's
         | legs. It's an accepted practice in every modern society to
         | prevent unnecessary pain, suffering, and death.
         | 
         | > Yet, we have an increasing number of venues, workplaces, and
         | events which are requiring proof of vaccination to participate.
         | This is forcing both people who already have antibodies, and
         | even people who can't make antibodies (e.g. immunocompromised,
         | solid organ transplant, etc), to undergo a medical procedure
         | for little to no benefit.
         | 
         | Getting a COVID vaccine is the only way you can help someone
         | who is immunocompromised since they can't take it. They have to
         | rely on the rest of us to provide relative herd immunity. Even
         | if you _think_ you have antibodies, getting a vaccine is the
         | best way to make sure, and allows health officials to make
         | informed decisions based on vaccination rates.
         | 
         | Why would you think there's no benefit to preventing painful
         | sickness and death for your neighbors? I have zero tolerance or
         | patience left for fair weather patriots who refuse wear a mask
         | or get a shot because maintaining their political identity is
         | more important than doing their best to make sure a fellow
         | citizen doesn't die alone in a COVID ward. It's a staggering
         | display of cowardice and selfishness.
         | 
         | Grow the fuck up. Wear a mask. Get the shot. It's the very
         | least you can do.
        
           | krona wrote:
           | > _and allows health officials to make informed decisions
           | based on vaccination rates._
           | 
           | Barely. Forecasting is being done on antibody levels at least
           | in countries that are running good real-time surveillance
           | studies. Hence why Israel/Germany/UK are deploying third
           | shots and many other countries will do the same.
        
       | Woodrow503 wrote:
       | Question: I've got the vaccine. I get a breakthrough case.
       | 
       | Is this a "best case" scenario for durable immunity?
        
         | jron wrote:
         | This seems like the most important unasked question. Common
         | sense would suggest the best case would be vaccination followed
         | by repeated exposure to the virus yet hardly anyone is talking
         | about it.
        
           | jjtheblunt wrote:
           | i wonder if that's what normally happens in nature across
           | many viruses. like a primed immune system exposed to a new
           | variant runs a minor "software update" now and then.
        
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